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Cancer and Financial Toxicity

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Cancer and financial toxicity are inextricably linked. I believe that financial toxicity is as dangerous as any environmental or genetic cause of cancer.

Multiple Myeloma First Line Treatment

According to the research linked and excerpted below, a “major financial event” (AFE) may precede a diagnosis or cancer or AFE’s contribute to a later stage diagnosis of cancer.

Is the study below saying that financial toxicity can cause cancer? A search for information on this question didn’t turn up and results. As a cancer survivor myself, what I can say is that

  • Financial toxicity can put a strain on your ;mind and body and
  • Financial toxicity while you have cancer can make it worse.

What is financial toxicity when talking about cancer?

Financial toxicity refers to the financial burden or distress experienced by individuals and families as a result of the costs associated with cancer treatment. Cancer treatment can be incredibly expensive, including costs for medications, hospital stays, surgeries, imaging tests, doctor visits, and other medical expenses. Additionally, individuals undergoing cancer treatment may experience loss of income due to time taken off work for treatment or recovery, or may even lose their jobs altogether.

Financial toxicity can lead to various challenges, including:

  1. Financial stress: The cost of cancer treatment can lead to significant financial strain on individuals and families, causing worry, anxiety, and uncertainty about how to afford treatment and manage ongoing expenses.
  2. Debt: Many individuals may need to take out loans, use credit cards, or dip into savings to cover the costs of cancer treatment, which can result in accumulating debt and financial instability.
  3. Impact on quality of life: Financial toxicity can affect a person’s ability to access necessary care and support services, impacting their overall quality of life during and after cancer treatment.
  4. Treatment decisions: Some individuals may be forced to make treatment decisions based on financial considerations rather than medical necessity, potentially compromising their health outcomes.
  5. Psychological distress: The stress of dealing with financial challenges alongside the physical and emotional toll of cancer can exacerbate psychological distress, leading to depression, anxiety, and other mental health issues.

Can Financial Toxicity cause cancer?

Financial toxicity refers to the financial burden that often accompanies a cancer diagnosis and treatment. While financial stress can certainly exacerbate existing health issues and impact overall well-being, there’s no direct evidence to suggest that financial toxicity alone can cause cancer.

However, the stress and anxiety resulting from financial difficulties can contribute to a variety of health problems, including:

  • high blood pressure,
  • weakened immune system,
  • and mental health issues.

Additionally, financial strain may lead individuals to delay seeking medical care or follow-up appointments, which can potentially impact cancer prognosis if treatment is delayed.

Ultimately, while financial toxicity itself may not directly cause cancer, its effects on mental and physical health can be significant and should be addressed as part of comprehensive cancer care.

What is the solution to this problem? It’s silly for me to sit here and tell you not to have adverse financial events. What I can say however, is that once you have been diagnosed with cancer:

Have you been diagnosed with cancer? What type? What stage? If you’d like to learn more managing your cancer, let me know- David.PeopleBeatingCancer@gmail.com

Hang in there,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Major Financial Toxicity Confers Later-Stage Cancer Diagnosis Risk

“Approximately one third of patients who are newly diagnosed with cancer experienced a major adverse financial event (AFE) before their diagnosis and AFEs were found to confer a higher risk of a later-stage diagnosis, according to findings from a study published in the Journal of Clinical Oncology.

Of 101,649 patients with cancer who had available LexisNexis data, 36,791 (36.2%) experienced a major AFE prior to their cancer diagnosis. Additionally, patients who were non-Hispanic Black had the highest rate of major AFEs before a diagnosis, including 45.2% of those in the Louisiana registry, 55.3% in the Seattle registry, and 59.7% in the Georgia registry. The rates of pre-diagnosis major AFEs for patients who were non-Hispanic Asian ranged from 16.6% in Seattle to 21.0% in Georgia. Investigators reported that 39.2% and 22.9% of unmarried and married patients, respectively, experienced an AFE.

A major AFE correlated with a later-stage cancer diagnosis for both male and female patients based on adjusted analyses.

“We found that one-third of patients newly diagnosed with cancer in this cohort had 1 or more major AFEs before their cancer diagnosis,” the study authors wrote.

“Having an AFE was associated with a later-stage diagnosis. Patients with a previous AFE not only face a greater likelihood of more advanced cancer but also may encounter barriers to receiving recommended care for their newly diagnosed cancer because of their pre-existing AFE. Our findings raise substantial concerns for the outcomes for people with an AFE before cancer diagnosis who are among the most vulnerable of all patients with cancer.”

Investigators collected patient data from the Seattle (Seattle-Puget Sound), Georgia, and Louisiana population-based Surveillance, Epidemiology, and End Results (SEER) registries. These registries contained patient’s date of birth, sex, marital status, race and ethnicity, disease type and stage at diagnosis, and number of primary tumors.

LexisNexis, a data aggregation company, provided information about estimated income levels and AFEs. Information related to AFEs pertained to 1 of 3 major types: a court record for bankruptcy, a lien, or eviction. Investigators assessed the relationship between major AFEs and stage III or IV cancer diagnoses using separate sex-specific multivariate logistic regression models…

Across the registries, 82.1% of patients were non-Hispanic White, 6.2% were non-Hispanic Asian, and 2.0% were non-Hispanic Pacific Islander individuals in Seattle. Additionally, non-Hispanic Black patients made up 29.4% and 31.0% of the Georgia and Louisiana populations, respectively.

The rates of major AFEs prior to a diagnosis for patients in the 2 lowest-income groups were 40% in Seattle and Louisiana and 50% in Georgia. Additionally, anywhere from 18.2% to 31.7% of those in the highest-income group had a major AFE before a diagnosis.

Among those with breast cancer, 17.1% of patients with a prior AFE had late-stage disease compared with 12.0% of those who had no prior AFE. The corresponding rates with respect to melanoma were 9.2% vs 5.3% among male patients and 5.9% vs 3.4% among female patients.


Warren JL, Mariotto AB, Stevens J, et al. Association of major adverse financial events and later-stage cancer diagnosis in the United States. J Clin Oncol. Published online February 6, 2024. doi:10.1200/JCO.23.01067

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